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A DEVICE FOR SIMPLIFYING THE MEASUREMENT OF CENTRAL VENOUS PRESSURE
684 Combined with
a
cardiovascular event-marker, such
as
the
The apparatus may then be resighted on it each time a measureis required. The prototype was constructed in the physics workshop at this hospital. It has been in constant use for over a year and
electrocardiogram, this system, with undoubted physical limitations, has proved a useful clinical aid in over 100 patients. Low investment and ease of assembling are additional attractive
ment
features. The unit
has proved most helpful. The Genito-Urinary Manufacturing Company Ltd., 33-34 Devonshire Street, London W.1, have now undertaken the manufacture;:’ :: a production model.
costs
less than E2 to assemble.
The
gramophone cartridge (G.P. 91/3) is obtainable from Cosmocord, Ltd., Eleanor Cross Road, Waltham Cross, Herts. Departments of Medicine, Clinical Cardiology, and Biophysics, Postgraduate Medical School, London W.12
J. A. ABBOTT M.D.
D. W. BETHUNE
D. HEMSLEY
A DEVICE FOR SIMPLIFYING THE MEASUREMENT OF CENTRAL VENOUS PRESSURE CENTRAL venous pressure is being increasingly used as a guide to cardiovascular status both during operation and also in the postoperative neriod.l-3 in the operating-theatre occasional raising and lowering of the table may be unavoidable and since the patient is draped with sterile towels it is often difficult to ensure that the scale zero is kept level with the reference point on the patient using the usual spirit level or pivoted beam (Sykes 1963). We have designed a simple device which enables a zero to be established without approaching the patient (see figs. 1 and 2). The apparatus con-" sists of a horizontal " gunsight mounted on a movable frame designed to take a Baxter ’BR 5 ’ central-venous-pressure set. The frame is attached to a standard intravenous drip stand by adjustable clamps. The sight is aimed at the chosen reference point-e.g., the manubriosternal angle or the mid-axillary line. If the patient is moved the clamps are released and the whole assembly is moved vertically until the sight is once again aimed at the reference point. If it is considered desirable to monitor central venous pressure in the postoperative period the particular reference point which has been used during the operation should be clearly marked before the patient leaves the theatre. 1.
Fig. 1-The device mounted on the scale centralwith the venouc-nreccure set.
Sykes,
M. K. Ann. R. Coll.
Surg.
1963, 33, 185. 2. MacLean, L. D. Surgery Gynec. Obstet. 1964, 118, 594. 3. Watkin, R. Br. J. Anœsth. 1965, 37, 428
M.B.
Durh.,
F.F.A. R.C.S.
G. B. GILLETT Lond., F.F.A., R.C.S. A. C. WATSON
M.B.
Departments of Anæsthesia and Medical Physics, St. Bartholomews Hospital,
M.R.C.S.,
D.A.
T. C. CRICHTON
London E.C.1.
CATHETER FOR BLADDER DRAINAGE DRAINAGE of the bladder after transvesical prostatectomy is not always adequate when a Foley catheter is used, because the small lumen prevents the evacuation of blood-clots. Super. vision of a patient during the night after operation may be poor where there is a shortage of trained nursing staff.
Catheter and terminal tube in position.
The catheter described here is in effect a Nelaton catheter with a fine tube attached to the end with two holes for
irrigation. The catheter is passed in the usual way and the fine terminal tube is brought out through the abdominal incision (see figure). When the catheter has been satisfactorily adjusted in the bladder, a piece of adhesive tape is attached to the irrigating tube and sutured to the skin. This catheter has three
advantages: (a(a
the lumen is unobstructed by a side tube for balloon inflation; (b) the catheter is self-retaining; and (c) continuous irngation can be given, or the bladder flushed out, when necessary. The irrigation tube is made in two sizes to take either the standard intravenousdrip needle or the Luer-Record attachment I thank Miss L. Pegus, of the medicai !:’ department of the Royal Marsden Hospital.fer
the illustration. Portland Plastics
The catheter is made ’" Kent.
Ltd., Hythe,
Charing Cross Hospital, London W.C.2
W. P. GREENING F.R.C.S.
a
cardiovascular event-marker, such
as
the
The apparatus may then be resighted on it each time a measureis required. The prototype was constructed in the physics workshop at this hospital. It has been in constant use for over a year and
electrocardiogram, this system, with undoubted physical limitations, has proved a useful clinical aid in over 100 patients. Low investment and ease of assembling are additional attractive
ment
features. The unit
has proved most helpful. The Genito-Urinary Manufacturing Company Ltd., 33-34 Devonshire Street, London W.1, have now undertaken the manufacture;:’ :: a production model.
costs
less than E2 to assemble.
The
gramophone cartridge (G.P. 91/3) is obtainable from Cosmocord, Ltd., Eleanor Cross Road, Waltham Cross, Herts. Departments of Medicine, Clinical Cardiology, and Biophysics, Postgraduate Medical School, London W.12
J. A. ABBOTT M.D.
D. W. BETHUNE
D. HEMSLEY
A DEVICE FOR SIMPLIFYING THE MEASUREMENT OF CENTRAL VENOUS PRESSURE CENTRAL venous pressure is being increasingly used as a guide to cardiovascular status both during operation and also in the postoperative neriod.l-3 in the operating-theatre occasional raising and lowering of the table may be unavoidable and since the patient is draped with sterile towels it is often difficult to ensure that the scale zero is kept level with the reference point on the patient using the usual spirit level or pivoted beam (Sykes 1963). We have designed a simple device which enables a zero to be established without approaching the patient (see figs. 1 and 2). The apparatus con-" sists of a horizontal " gunsight mounted on a movable frame designed to take a Baxter ’BR 5 ’ central-venous-pressure set. The frame is attached to a standard intravenous drip stand by adjustable clamps. The sight is aimed at the chosen reference point-e.g., the manubriosternal angle or the mid-axillary line. If the patient is moved the clamps are released and the whole assembly is moved vertically until the sight is once again aimed at the reference point. If it is considered desirable to monitor central venous pressure in the postoperative period the particular reference point which has been used during the operation should be clearly marked before the patient leaves the theatre. 1.
Fig. 1-The device mounted on the scale centralwith the venouc-nreccure set.
Sykes,
M. K. Ann. R. Coll.
Surg.
1963, 33, 185. 2. MacLean, L. D. Surgery Gynec. Obstet. 1964, 118, 594. 3. Watkin, R. Br. J. Anœsth. 1965, 37, 428
M.B.
Durh.,
F.F.A. R.C.S.
G. B. GILLETT Lond., F.F.A., R.C.S. A. C. WATSON
M.B.
Departments of Anæsthesia and Medical Physics, St. Bartholomews Hospital,
M.R.C.S.,
D.A.
T. C. CRICHTON
London E.C.1.
CATHETER FOR BLADDER DRAINAGE DRAINAGE of the bladder after transvesical prostatectomy is not always adequate when a Foley catheter is used, because the small lumen prevents the evacuation of blood-clots. Super. vision of a patient during the night after operation may be poor where there is a shortage of trained nursing staff.
Catheter and terminal tube in position.
The catheter described here is in effect a Nelaton catheter with a fine tube attached to the end with two holes for
irrigation. The catheter is passed in the usual way and the fine terminal tube is brought out through the abdominal incision (see figure). When the catheter has been satisfactorily adjusted in the bladder, a piece of adhesive tape is attached to the irrigating tube and sutured to the skin. This catheter has three
advantages: (a(a
the lumen is unobstructed by a side tube for balloon inflation; (b) the catheter is self-retaining; and (c) continuous irngation can be given, or the bladder flushed out, when necessary. The irrigation tube is made in two sizes to take either the standard intravenousdrip needle or the Luer-Record attachment I thank Miss L. Pegus, of the medicai !:’ department of the Royal Marsden Hospital.fer
the illustration. Portland Plastics
The catheter is made ’" Kent.
Ltd., Hythe,
Charing Cross Hospital, London W.C.2
W. P. GREENING F.R.C.S.